National Trends in Utilization of Speech-Language Pathology and Otolaryngology Services for Dysphonia

Dysphonia affects a growing number of individuals in the United States, but many do not receive targeted care. This study explores trends in speech-language pathology (SLP) and otolaryngology utilization in a large, national cohort of individuals with dysphonia.

Of 287,012 participants with EHR data who enrolled in the NIH All of Us Research Program between May 2018 and July 2022, those with dysphonia were identified using ICD codes. SLP and otolaryngology utilization rates were determined using CPT codes for relevant diagnostic and therapeutic interventions. Multivariate logistic regression analyses evaluated associations between sociodemographic characteristics and specialist care.

Of 8308 individuals with dysphonia, 4136 (49.8%) received specialist care, with 1740 (20.9%) having utilized SLP services and 3973 (47.8%) having utilized otolaryngology services. In adjusted analyses, older age, female sex, and lower education were associated with decreased SLP utilization, while female sex and lower income were associated with decreased otolaryngology utilization. Higher rates of otolaryngology utilization were seen in individuals identifying as Black or Other versus Non-Hispanic White. Insurance status and rural location did not independently correlate with specialist utilization.

49.8% of individuals with dysphonia accessed specialist care, with 20.9% of the individuals with dysphonia receiving SLP services and 47.8% receiving otolaryngology services. Utilization rates varied significantly across age, sex, race and ethnicity, education level, and annual income, but not insurance status or geographical setting.

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